Drug Interactions
Since probiotics contain live microorganisms, concurrent administration of antibiotics could kill a large number of the organisms, reducing the efficacy of the Lactobacillus and Bifidobacterium species. Patients should be instructed to separate administration of antibiotics from these bacteria-derived probiotics by at least two hours.[58,72] Similarly, S. boulardii might interact with antifungals, reducing the efficacy of this probiotic.[73] According to the manufacturer, Florastor, which contains S. boulardii, should not be taken with any oral systemic antifungal products.[74] Probiotics should also be used cautiously in patients taking immunosuppressants, such as cyclosporine, tacrolimus, azathioprine, and chemotherapeutic agents, since probiotics could cause an infection or pathogenic colonization in immunocompromised patients.[58,72,73]
Am J Health Syst Pharm. 2010;67(6):449-458. © 2010 American Society of Health-System Pharmacists
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